RESPONDING TO SYMPTOMS

EKARINA RATNA HIMAWATI

FAKULTAS FARMASI UNIVERSITAS AIRLANGGA 2012

TUJUAN PEMBELAJARAN UMUM

Setelah

mengikuti mata ajaran ini, diharapkan mahasiswa mampu berpikir komprehensif untuk membuat keputusan profesi (Professional Judgement) dalam penerapan Pharmaceutical Care kepada pasien atau klien atas dasar Responding to Symptoms.

TUJUAN PEMBELAJARAN KHUSUS

1.

2.

3.

Mahasiswa mampu menerapkan unsur unsur dan tahapan tahapan dalam melakukan Responding to symptoms. Mahasiswa mampu menerapkan keterampilan berkomunikasi dalam rangka responding to symptoms. Mahasiswa mampu menyelesaikan masalah kesehatan masyarakat dan prinsip prinsip nutrisi terkait dengan penyakit dan pengobatannya.

TUJUAN PEMBELAJARAN KHUSUS

4. Mahasiswa mampu membuat keputusan profesi yang berupa rekomendasi obat, tanpa obat, dan/atau merujuk ke profesi kesehatan lain saat melakukan responding to symptoms. 5. Mahasiswa mampu melakukan patient counceling pada saat menyerahkan obat.

METODE PEMBELAJARAN

Mata Ajaran ini disajikan dengan metode Problem-Based Learning dalam kelas-kelas kecil (10-12 mahasiswa tiap kelas), masingmasing didampingi 2 tutor. Beban SKS: 1 SKS dengan alokasi waktu 6 x tatap muka a 100 menit (sistem blok).

MATERI PEMBELAJARAN

Problema yang akan disajikan dan diselesaikan adalah 4 problema yang sedang aktual di masyarakat Indonesia, meliputi: 1. gejala konstipasi 2. gejala diare spesifik 3. gejala diare non spesifik 4. gejala diare kronis yang mengarah ke infeksi HIV

Paradigma Praktek Kefarmasian

PARADIGMA ASUHAN KEFARMASIAN (PHARMACEUTICAL CARE)

PRODUCT ORIENTED

PATIENT ORIENTED

Pelayanan Kefarmasian di Apotek

Resep Non resep (Swamedikasi)

Dengan keluhan atau gejala sakit

Dengan permintaan obat spesifik

Metode: WWHAM,

ASMETHOD, ENCORE, SIT DOWN SIR

Patient Assessment
Rekomendasi

Gejala Berat

Gejala Ringan

Dirujuk ke Dokter

Terapi Non Obat

Terapi Obat

METODE PATIENT ASSESSMENT W Who is the patient? W What are the symptoms? H How long have the symptoms been present? A Action already taken; what medicines have been tried? M Medication being taken for other problems? S Site or location? I Intensity or severity? T Type or nature? D Duration? O Onset? W With (other symptoms)? N aNnoyed or aggravated by? S Spread or radiation? I Incidence or frequency pattern? R Relieved by?

A S M E T T H O D

Age and appearance of the patient? Self or someone else? Medication the patient is taking? Exactly what does the patient mean by the symptoms? Time/duration of symptomps? Taken anything for it or seen the doctor? History of any disease or condition? Other symptoms being experienced? Doing anything to aggravate or alleviate the condition?

E Explore N No medication C Care O Observe R Refer E Explain

Ketrampilan yg dibutuhkan farmasis dalam responding to symptoms:

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2.
3.

4. 5.

6.
7.

Knowledge of disease and their treatment Astute observation Excellent communication and questioning skills to obtain all the information required to make a decision about whether to treat or refer. Selection of the most suitable treatment Explaining how to use the treatment Provision of advice on related health care and Informing the patient of the action to take if symptoms do not improve within appropriate time scales.

A suggested sequence for responding to symptoms is:

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2.

3.

4.

Listening and questioning: to obtain information about symptoms. Decision-making: is referral for a medical opinion required? Treatment: the selection of an appropriate and effective preparation (where needed) and advising on its use. Outcome: telling the patient what action to take if the symptoms do not improve.

Decision making: is referral required?

As a general rule, the following should make the pharmacist consider referring the patient to the doctor: 1. Long duration of symptoms 2. Recurring or worsening problems 3. Severe pain 4. Failed medication (one or more appropriate medicines used already without improvement) 5. Suspected adverse drug reactions (to prescription or OTC medicine) 6. Danger symptoms.

Danger symptoms which should be referred for medical investigation

Ankle swelling Blood in stools or vomit may be associated with internal bleeding Unexplained weight (loss anorexia) may be associated with a malignancy Difficulty in swallowing (obstructions) History of severe and paricularly penetrating injury Increasing breathlessness Menstrual abnormality Pain in the chest, abdomen, head or ears Persistent or recurrent pyrexia

Danger symptoms which should be referred for medical investigation

Spontaneous bruising Swelling or lumps of any size (malignancies) Tenderness over the blood vessels Urinary symptoms (possible infection) Yellow or green discharge from the penis or vagina (underlying infection) Yellow or green sputum (infected discharge) Yellow skin colour (jaundice)

RANGKUMAN
Peran Farmasis dalam Pelayanan swamedikasi menuntut pemahaman yang komprehensif tentang penyakit dan gejala yang menyertainya, terapi obat dan non obat yang dibutuhkan, serta ketrampilan berkomunikasi dan mengambil keputusan dalam responding to symptoms. Farmasis harus mampu membuat keputusan yang tepat untuk membuat rekomendasi terapi obat, terapi non obat atau merujuk ke dokter saat melayani pelaku swamedikasi.

DAFTAR PUSTAKA

Blenkinsopp, A., Paxton, P., dan Blenkinsopp, J., 2009. Symptoms in the Pharmacy, Edisi ke-6, Massachusetts: Blackwell Publishing. Departemen Kesehatan Republik Indonesia, 2004. Keputusan Menteri Kesehatan Republik Indonesia Nomor 1027/MENKES/SK/IX/2004 tentang Standar Pelayanan Kefarmasian di Apotek. Jakarta: Direktorat Jendral Pelayanan Kefarmasian dan Alat Kesehatan Departemen Kesehatan RI Rovers, J. P., Currie, J.D., Hagel, H. P., McDonough, R.P., and Sobotka, J. L., 1998. A Practical Guide to Pharmaceutical Care. Washington, D. C.: American Pharmaceutical Association

THANK YOU